When to have surgical treatment for cleft lip and cleft palate

  The outcome of cleft lip and palate treatment depends on the timing of treatment and the choice of method, i.e. the ability to choose the right method at the right time. Professional and delicate treatment has a great impact on the patient’s appearance, voice recovery, improvement of facial development and psychosocial adaptation. The surgical treatment of cleft lip and palate mainly includes cleft lip repair, cleft palate repair, alveolar cleft implantation and nasolabial deformity correction. Orthodontic treatment, orthognathic surgery and cosmetic surgery should also be performed if available to achieve a more perfect result.  The child should see an oral and maxillofacial surgeon or plastic surgeon as soon as possible after birth. The doctor will develop a more specific treatment plan for the child depending on the cleft. If you do not have access to a doctor, you can refer to the following treatment schedule  Initial pre-surgical orthodontic treatment: for more severe complete cleft lip and alveolar cleft. The application of nasal-alveolar orthodontic appliances not only displaces the protruding alveolar bone downward and backward, reducing the cleft, but also corrects the flattened nostril, creating favorable conditions for the next surgical result.  1.3 months after birth: unilateral cleft lip repair is performed.  2.6 months after birth: Bilateral cleft lip repair is performed.  3.8-18 months after birth: cleft palate repair. Severe bilateral complete cleft palate can be delayed until one and a half years of age or later.  4.3-4 years old: voice training can be performed. Children with maxillary dysplasia can be treated with orthodontic intervention.  5.4-5 years old: pharyngoplasty or cleft palate re-repair is performed.  6.5-6 years old: lip and nose deformities are repaired and psychological counseling is available.  7.9-11 years old: Bone grafting for cleft teeth.  8.13-16 years old: more serious cleft lip and nose deformity correction.  9.After the age of 16-18: orthodontic-orthognathic surgical treatment for jaw deformities (e.g., large chin) 10.After the age of 18: cosmetic surgical treatment to adjust the nose, lips, eyes and facial morphology to a coordinated aesthetic effect.  After the birth of a child with cleft lip, the parents of the child are under great psychological pressure and are mostly anxious for early surgical repair. Some medical units carry out treatment programs for immediate postnatal repair, but because the anatomical landmarks of the child’s lip are not yet clear, it is difficult to achieve a more ideal repair result. Based on the child’s nutritional development, the body’s ability to tolerate the surgery, the certainty of the delicate operation, and the impact of the surgery on the child’s facial development, in most cases, it is safer and more reliable to wait until the child is 3-6 months old, weighs 6-7 kg, and has a hemoglobin of not less than 10 gM100 ml.